Improving Order-Entry Competency: Insights from Interprofessional Stakeholders to Inform Medical Education.

内容摘要

Accurate and complete order entry is an essential skill for all medical graduates. However, medical students report limited confidence in performing this task. This study examined stakeholder perspectives on order entry to identify educational gaps and inform curriculum development. This phenomenological, qualitative study was performed from November 2024 to May 2025 with semistructured interviews of interprofessional stakeholders at the University of Nebraska Medical Center regarding their perceptions of common and high-consequence errors in order entry by new physicians and suggestions for needed education. Stakeholders included inpatient nurses, inpatient pharmacists, interns, and supervising physicians. Analysis was performed using open inductive coding. Eight themes emerged from qualitative analysis of 17 stakeholder interviews. Education and training highlighted the need for both formal and informal instruction on order entry, medication management, and institutional protocols. Contextual awareness emphasized the importance of critically evaluating order appropriateness and identifying inconsistencies. Collaboration in care underscored the role of interprofessional teamwork and communication in reducing errors. Oversight and accountability revealed that early trainees often rely on pharmacists and nurses to catch mistakes, highlighting the need for structured supervision and personal responsibility. Optimizing order systems addressed how electronic health record design, including order sets, prepopulated fields, and decision support, affects accuracy and efficiency. Special populations and vulnerable moments identified increased risk of errors in pediatric, renal, and transitional care scenarios. Informed decision-making reflected gaps in clinical knowledge related to medication selection, dosing, and interactions. Precision in practice stressed the importance of paying attention to detail, verifying accuracy, and balancing speed with thoroughness in order entry. New physicians face multifaceted challenges in mastering order entry, underscoring the need for integrated, longitudinal, and interprofessional educational approaches. Although targeted interventions can improve confidence and competence, sustained practice, reflective learning, and supportive system design are essential for developing durable proficiency.